Hair Loss

Last Updated: September 29, 2022

Hair loss can affect the scalp or other areas of the body where hair grows and may occur gradually or suddenly and dramatically. It may result from aging, genetics, hormonal changes, or medical conditions.

Hair Loss falls under theSkin, Hair, & Nailscategory.

What is hair loss?

Hair loss, also known as alopecia, refers to the loss of hair on the body. There are various types of hair loss, all of which tend to differ in their underlying causes, prevalence, and the pattern in which hair is lost. Common types of hair loss include male- and female-pattern hair loss (collectively referred to as androgenic alopecia; AGA), alopecia areata, telogen effluvium, and anagen effluvium.[1]

What are the main signs and symptoms of hair loss?

Male-pattern hair loss typically begins with hair loss at the front of the hairline and/or on the crown of the head, with hair loss progression over time.[2] Female-pattern hair loss tends to feature diffuse hair thinning and hair loss across the top of the head, especially near the center of the scalp.[2] Alopecia areata involves hair loss in patches, which can regrow or precede complete loss of hair. Telogen effluvium and anagen effluvium both involve hair thinning and hair loss across the scalp.

How is hair loss diagnosed?

A medical professional may use various methodologies to diagnose hair loss, including visual examination, medical history, biopsy, and laboratory testing.[3]

One procedure often employed is a hair pull test.[4] In this test, a small section of hair is grasped and gently pulled on, with the process repeated at various areas of the scalp. The number of hairs that come out upon pulling can indicate if hair loss is occurring and its severity.

What are some of the main medical treatments for hair loss?

The only two drugs currently approved by the FDA for the treatment of androgenic alopecia are minoxidil (used topically) and finasteride (taken orally).[1] Of these, minoxidil is approved for the treatment of both male- and female-pattern hair loss, while finasteride is only approved for men with male-pattern hair loss. Other treatments used for androgenic alopecia include dutasteride, prostaglandin analogs (e.g., latanoprost), injection with platelet-rich plasma, and anti-androgens (for women with hair loss due to high androgen levels).

The first-line treatment for alopecia areata is the injection of corticosteroids into sites of hair loss.[5]

Have any supplements been studied for hair loss?

Several RCTs have tested the effect of individual supplements on hair loss, given either orally (including vitamin E and saw palmetto) or applied topically to the scalp (including pumpkin seed oil, melatonin, and procyanidin from apples).[6] A number of studies have also examined the effect of oral supplements containing a mixture of compounds, typically a combination of nutrients (e.g., amino acids and vitamins).

How could diet affect hair loss?

Research on the effect of diet on hair loss is very limited. One small case-control study found that men with high intakes of either raw vegetables or fresh herbs were less likely to have AGA.[7] In rare cases, certain nutrient deficiencies may lead to hair loss (especially in susceptible individuals), with one example being iron deficiency anemia.[8]

Are there any other treatments for hair loss?

Red light therapy involves the application of red and infrared light onto areas of the scalp, and available evidence indicates LLLT can prevent hair loss and potentially support hair regrowth in AGA.[9]

Microneedling (a procedure in which the skin is repeatedly punctured by a large number of very small needles) may be able to enhance the effects of minoxidil in preventing hair loss and producing hair regrowth in AGA.[10]

Ketoconazole is an antifungal medication that may reduce hair loss and potentially promote hair regrowth in AGA when applied to the scalp via medicated shampoo.[11]

What causes hair loss?

Male-pattern baldness is due in large part to an androgen (a so-called “male hormone") called dihydrotestosterone (DHT), which can sometimes contribute to female-pattern baldness as well. Other factors – like aging and genetics – can also increase the risk of male- and female-pattern baldness.

Alopecia areata is the result of the body's immune cells attacking hair follicles, resulting in inflammation and eventual hair loss.

Hair loss can also be the result of medical conditions, medications, and infection.

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  2. ^Ho CH, Sood T, Zito PMAndrogenetic AlopeciaStatPearls.(2021-11)
  3. ^T Grant Phillips, W Paul Slomiany, Robert AllisonHair Loss: Common Causes and TreatmentAm Fam Physician.(2017 Sep 15)
  4. ^Katherine A McDonald, Amanda J Shelley, Sophia Colantonio, Jennifer BeeckerHair pull test: Evidence-based update and revision of guidelinesJ Am Acad Dermatol.(2017 Mar)
  5. ^Kenia Lepe, Patrick M. ZitoAlopecia Areata
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  9. ^Andjela Egger, Sydney R Resnik, Divya Aickara, Eric Maranda, Michael Kaiser, Tongyu C Wikramanayake, Joaquin J JimenezExamining the Safety and Efficacy of Low-Level Laser Therapy for Male and Female Pattern Hair Loss: A Review of the LiteratureSkin Appendage Disord.(2020 Sep)
  10. ^Robert S English Jr, Sophia Ruiz, Pedro DoAmaralMicroneedling and Its Use in Hair Loss Disorders: A Systematic ReviewDermatol Ther (Heidelb).(2022 Jan)
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  15. ^Olsen EA, Hordinsky M, Whiting D, Stough D, Hobbs S, Ellis ML, Wilson T, Rittmaster RS,The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride.J Am Acad Dermatol.(2006-Dec)
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  21. ^Hamada K, Randall VAInhibitory autocrine factors produced by the mesenchyme-derived hair follicle dermal papilla may be a key to male pattern baldnessBr J Dermatol.(2006 Apr)
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  23. ^Nyholt DR, Gillespie NA, Heath AC, Martin NGGenetic basis of male pattern baldnessJ Invest Dermatol.(2003 Dec)
  24. ^Rathnayake D, Sinclair RMale androgenetic alopeciaExpert Opin Pharmacother.(2010 Jun)
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Examine Database References
  1. Hair Regrowth - Arca E, Açikgöz G, Taştan HB, Köse O, Kurumlu ZAn open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopeciaDermatology.(2004)
  2. Hair Regrowth - Berger RS, Fu JL, Smiles KA, Turner CB, Schnell BM, Werchowski KM, Lammers KMThe effects of minoxidil, 1% pyrithione zinc and a combination of both on hair density: a randomized controlled trialBr J Dermatol.(2003 Aug)
  3. Hair Regrowth - Ulrike Blume-Peytavi, Kathrin Hillmann, Ekkehart Dietz, Douglas Canfield, Natalie Garcia BartelsA randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in womenJ Am Acad Dermatol.(2011 Dec)
  4. Hair Regrowth - Price VH, Menefee E, Strauss PCChanges in hair weight and hair count in men with androgenetic alopecia, after application of 5% and 2% topical minoxidil, placebo, or no treatmentJ Am Acad Dermatol.(1999 Nov)
  5. Hair Regrowth - Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, Trancik RJA randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in menJ Am Acad Dermatol.(2002 Sep)
  6. Hair Regrowth - Olsen EA, Whiting D, Bergfeld W, Miller J, Hordinsky M, Wanser R, Zhang P, Kohut BA multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in menJ Am Acad Dermatol.(2007 Nov)
  7. Hair Regrowth - Lucky AW, Piacquadio DJ, Ditre CM, Dunlap F, Kantor I, Pandya AG, Savin RC, Tharp MDA randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair lossJ Am Acad Dermatol.(2004 Apr)
  8. Hair Regrowth - Tsuboi R, Arano O, Nishikawa T, Yamada H, Katsuoka KRandomized clinical trial comparing 5% and 1% topical minoxidil for the treatment of androgenetic alopecia in Japanese menJ Dermatol.(2009 Aug)
  9. Hair Regrowth - Rossi A, Mari E, Scarno M, Garelli V, Maxia C, Scali E, Iorio A, Carlesimo MComparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year studyInt J Immunopathol Pharmacol.(2012 Oct-Dec)
  10. Hair Regrowth - Beoy LA, Woei WJ, Hay YKEffects of tocotrienol supplementation on hair growth in human volunteersTrop Life Sci Res.(2010 Dec)
  11. Hair Regrowth - Lueangarun S, Visutjindaporn P, Parcharoen Y, Jamparuang P, Tempark TA Systematic Review and Meta-analysis of Randomized Controlled Trials of United States Food and Drug Administration-Approved, Home-use, Low-Level Light/Laser Therapy Devices for Pattern Hair Loss: Device Design and Technology.J Clin Aesthet Dermatol.(2021-Nov)